EMF/SAEMF Medical Student Research Grant

Please read these instructions carefully. Applications that do not follow these
instructions with regards to typesize, length, format, and supporting
documentation will be summarily rejected. If the grant application deadline has
not passed, the application may be resubmitted after deficiencies are addressed.
No extension of the deadline will be granted to allow resubmission in this cycle.

Before submitting your application, please be sure that the following items have been addressed:

Information page is included as the first page of the application packet and is fully completed

Type size is no smaller than 15 characters per inch (use 12-pt. font if you are unsure)

Support letters from the preceptor and chair of the department or division of emergency medicine or
program director are included in the application packet.

Evidence of IRB/AUC approval, or at least evidence of submission to IRB/AUC, is included in

application packet

Signed Statement of Conditions is included in application packet

Other grant support for the proposed project is included in application packet

Submission via our on-line application system is required. Late applications will not be considered.
http://www.emfoundation.org/applyforagrant/

EMF/SAEMF MEDICAL STUDENT RESEARCH GRANT

GENERAL INFORMATION
2015-2016
Deadline for receipt of application:
Notification of award
Funding

February 6, 2015
May 2015
July 1, 2015 - June 30, 2016

INTRODUCTION
The Emergency Medicine Foundation (EMF) and Society for Academic Emergency Medicine Foundation
(SAEMF) jointly award stipends to encourage medical students to engage in and to be exposed to emergency
medicine research.
ELIGIBILITY
An application for an EMF/SAEMF Medical Student Research Grant may be made by either a specific medical
student or by an Emergency Medicine residency program wishing to sponsor a medical student research project. The
specific medical student does not need to be identified at the time of application submission; however, preference
will be given to an institution naming a specific student who has already committed to the project. Proposals
approved for funding that do not name a student are not guaranteed funding. In theses cases, funds will be awarded
on a first come, first served basis (when EMF is informed in writing that a student has committed to the project). The
maximum number of awards funded will be determined annually by the EMF Board. Although an institution may
receive multiple awards, only one application per research program (laboratory or clinical investigator) will be
awarded.
DEFINITION OF EMERGENCY MEDICINE RESEARCH
Emergency medicine research is broadly defined as scientific investigation designed to furnish new knowledge
relating to emergency medical care. Such investigations may focus on basic science research, clinical research,
preventive medicine, epidemiology, cost-containment, and research in emergency medicine teaching and education.
INSTITUTIONAL SUPPORT
The applicant is required to demonstrate that the project will be successfully completed at his or her institution.
The applicant must demonstrate that access to a suitable caseload or patient population will be available for study
during the funding period if a clinical research project is proposed. If a basic science or nonclinical project is
proposed, the applicant must show that adequate and appropriately equipped laboratory space will be available
during the funding period. Research involving animals or human subjects must be approved by the institutional
review board (IRB), or its equivalent. A copy of the approval, or pending approval, must be sent with this
application. IRB approval must be documented prior to dispensation of EMF funds.
EVALUATION OF APPLICATIONS
Each proposal will be evaluated by a committee composed of individuals from EMF and SAEMF according to
the following criteria:
1.
2.
3.
4.
5.
6.

Relevance to the goals of the Medical Student Research Grant program.

Educational experience for the applicant.
The quality and scientific value of the project.
The research background and experience of the preceptor.
The preceptors ability to mentor.
Institutional support personnel, facilities, and commitment to research.

The final funding decision will be made by the Emergency Medicine Foundation and all decisions are final.

TERMS OF THE GRANT

Duration and Amount
The grant is for a maximum of $5,000 at least $2,500 which must be used as a student stipend. The grant is
awarded to a student's institution and may not be used for faculty salary support, institutional overhead, or capital
expenditures. The medical student's and/or preceptor's own institution may supplement the EMF/SAEMF Medical
Student Research Grant within the guidelines set by that institution. Audited reports detailing how the funds were
used may be required. Applicants can reapply each academic year for a second term of support on a competitive
basis.
Limitations of Grant
EMF and SAEMF are not fiscally responsible for funds necessary to complete the research project(s), nor will
EMF or SAEMF be responsible for institutional overhead. If the preceptor changes institutional affiliations before
completion of the medical student's term, the award will be terminated and the remaining balance returned to EMF. If
a suitable new preceptor can be found, the award may be continued.
Patent Policy
The recipient and preceptor's institution acknowledge that if a patentable invention or discovery is conceived, or
conceived and reduced to practice by the EMF/SAEMF Medical Student Research Grant recipient during the term of
the award, EMF must be apprised of the invention and the institution's plans for protecting such invention or
discovery under an existing institutional patent policy.
Liability of EMF and SAEMF
EMF and SAEMF assume no financial liability if patient care responsibilities of any kind are undertaken by the
designated EMF/SAEMF Medical Student Research Grant recipient. The preceptor and the recipient's institution
acknowledge that EMF and SAEMF are not legally liable for the conduct of the designated recipient, preceptor(s), or
associate investigator(s).
Human Subjects
If the proposed project involves the use of human subjects, appropriate Institutional Review Board approval must
be obtained. Include IRB approval in the Appendix.
Animal Research
If the proposed project involves the use of animals, the applicant must demonstrate that adequate and
appropriately equipped laboratory space will be available during the funding period to facilitate completion of the
proposed project. The applicant and institution must certify that research involving animals will conform to the
"Guiding Principles in the Care and Use of Animals" approved by the Council of the American Physiological
Society.
PROGRESS REPORTS AND MONEY MANAGEMENT
The principal investigator is required to submit a mid-year and final progress report. Additional reports may be
required. Failure to provide such reports will delay transmission of funds. Furthermore, failure to provide interim
and final reports to the Foundation may negatively impact your institutions ability to apply for future EMF awards.
EMF will maintain the copyright of all such reports. Progress reports must include an accounting report using
Generally Accepted Accounting Procedures showing the distribution of funds with a signature from an institutional
official (e.g., accountant, grants manager, administrator from the Office of Sponsored Research). The EMF reserves
the right to withhold release of interim funds if >25% of the previous cycle remains unspent.
SURVEYS
The principal investigator and the institution will be surveyed periodically following completion of the award
regarding career paths, subsequent grants/contracts obtained, and publications. The principal investigator and the

institution will be expected to respond to these surveys as the Emergency Medicine Foundation will rely on such
information to support continuation of the award program.
GRANTEE WORKSHOP
Grant recipients will be expected to attend a grantee workshop. The workshop is designed to bring together EMF
and SAEMF grant recipients to present their progress and discuss any problems they may be facing. Senior
researchers and faculty will be available to help solve problems that are potentially bogging down research projects,
manage staff, and balance life. Travel expenses will be reimbursed by the Emergency Medicine Foundation.
RESEARCH FORUM
Awardees are required to present their work at the American College of Emergency Physicians Scientific
Assembly/Research Forum immediately following the completion of the award year as a poster presentation. Funds
cannot be requested to cover the travel cost to attend the Research Forum, although the Scientific Assembly/Research
Forum registration fee is waived for the presenter.
PUBLICATIONS
Publications resulting from the research project should acknowledge the support of EMF and SAEMF (i.e., "This
study has been supported in part by a grant from the Emergency Medicine Foundation and the Society for Academic
Emergency Medicine Foundation"). Two reprints of each publication should be forwarded to the Emergency
Medicine Foundation.
ACADEMIC CREDIT
Academic credit for research conducted under the EMF/SAEMF Medical Student Research Grant program will
be granted according to the guidelines set forth by the recipient's institution.

APPLICATION INSTRUCTIONS
Submission in electronic format is required. No paper copies please. Please fill out the detailed questionnaire about your
grant application on the link on our EMF grant page. Be prepared to submit information about your project including
where the name and address of your institution, detailed information about where the check will be sent, and names of
your mentor, fiscal officer, etc. Once the questionnaire is completed, you will need to press submit then you will be
guided to the next page where you can upload your application in a PDF format. Please note, the completed file cannot be
larger than 10MB. INCOMPLETE PROPOSALS OR PROPOSALS RECEIVED AFTER THE DEADLINE
DATE INDICATED UNDER GENERAL INFORMATION WILL NOT BE CONSIDERED.
Use English only and avoid jargon and unusual abbreviations. For terms not universally known, spell out the term the
first time it is used with the appropriate abbreviation in parentheses; the abbreviation may be used thereafter. Type
the application, single-spaced, and stay within the margin limitations indicated on the forms and continuation pages.
The type must be clear and readily legible, no smaller than 15 characters per inch. (If in doubt, use 12 pt. size font.)
Finally, there must be no more than six lines of text within a vertical inch. Use black type; do not use photoreduction.
Do not submit an incomplete application. An application will be considered incomplete if it is illegible, if it fails
to follow instructions, or if the material presented is insufficient to permit an adequate review. Unless
specifically required by these instructions (e.g. human subjects certification, vertebrate animals verification) do not
send supplementary material.
The application is to be submitted using the enclosed forms. Number the pages consecutively at the bottom
throughout the application. Do not use suffixes such as 5a, 5b. Type the name of the Mentor at the top of each printed
page. AN APPLICATION WILL NOT BE CONSIDERED IF PAGE LIMITATIONS ARE NOT
OBSERVED.
The application consists of the following sections:
1.

INFORMATION PAGE
Name the one person responsible to the applicant organization for the scientific and technical direction of the
project. Choose a title that is descriptive and specifically appropriate, rather than general. List the Mentor and
any associate investigators.

2.

ABSTRACT
Brief summary of educational program and research proposal. Include coursework (or degree) to be completed
and rationale, research hypothesis, specific aims, and significance.

3.

TABLE OF CONTENTS

4.

INTRODUCTION TO REVISED APPLICATION, if applicable. (limit 2 pages)

EMF will consider revised proposals, and two additional pages are provided to introduce reviewers to the
revised proposal. Key things to keep in mind when submitting a revised grant:
a.

b.
c.

The introduction to the revision should provide a concise summary of reviewers' comments from the
previous application and should, point-by-point, discuss how the revised application has addressed
these concerns.
Revised applications are not reviewed outside of the normal review process. Such applications may be
more competitive than first-time submissions, but not necessarily so.
Revised applications are reviewed as new science. Revised applications will not automatically be

d.

5.

considered better applications within the review process.

In the event of a resubmission, the committee will attempt to return applications to their original
reviewers when possible. However, regular turn-over of the committee membership prevents the SRC
from guaranteeing that a grant will be reviewed by the same individuals reviewing the original
application.

RESEARCH PROPOSAL (limit 2 pages)

Use NIH form Continuation Format Page available on the internet at
www.grants.nih.gov/grants/funding/phs398/phs398.html#
Please use the following subheadings:
Specific Aims (limit 1 page)
State concisely the goals of the proposed research and summarize the expected outcome(s), including the
impact that the results of the proposed research will exert on the research field(s) involved.
List succinctly the specific objectives of the research proposed, e.g., to test a stated hypothesis, create a novel
design, solve a specific problem, challenge an existing paradigm or clinical practice, address a critical barrier
to progress in the field, or develop new technology.
Specific Aims are limited to one page.
Significance
Explain the importance of the problem or critical barrier to progress in the field that the proposed project
addresses.
Explain how the proposed project will improve scientific knowledge, technical capability, and/or clinical
practice in one or more broad fields.
Describe how the concepts, methods, technologies, treatments, services, or preventative interventions that
drive this field will be changed if the proposed aims are achieved.
Innovation
Explain how the application challenges and seeks to shift current research or clinical practice paradigms.
Describe any novel theoretical concepts, approaches or methodologies, instrumentation or interventions to
be developed or used, and any advantage over existing methodologies, instrumentation, or interventions.
Explain any refinements, improvements, or new applications of theoretical concepts, approaches or
methodologies, instrumentation, or interventions.
Approach
Describe the overall strategy, methodology, and analyses to be used to accomplish the specific aims of the
project.
Discuss potential problems, alternative strategies, and benchmarks for success anticipated to achieve the
aims.
If the project is in the early stages of development, describe any strategy to establish feasibility, and
address the management of any high risk aspects of the proposed work.
Preliminary Studies. Include information on Preliminary Studies. Discuss the PD/PIs preliminary
studies, data, and or experience pertinent to this application. Preliminary data can be an essential part of a
research grant application and help to establish the likelihood of success of the proposed project.

6.

PERSONAL STATEMENT (limit 1 page)

Use the NIH form Continuation Format Page
The applicant should compose and submit a personal statement that addresses:
a.
the applicants interest in the topic and this project
b. the applicants perception of his/her role in the project
c.
any additional pertinent experience or interests the applicant wishes the committee to consider

7. LETTER OF SUPPORT FROM PRECEPTOR (limit 1 page)

This grant is intended to supply salary support for the medical student and the preceptors letter must indicate
at least half the funds will be spent for the medical students stipend. Include a letter from the preceptor
expressing support for the project and describing his or her qualifications as preceptor and involvement in the
proposed research project. The letter should also highlight the preceptors intended work with the student.
The preceptors primary appointment must be in the department or division of emergency medicine.
8.

ROLE OF PARTICIPANTS (limit 1 page)

Use the NIH form Continuation Format Page
www.grants.nih.gov/grants/funding/phs398/phs398.html#
List the Mentor and each associate investigator and consultant. Include a brief description of how and to what
extent each will be involved in the proposed project. Describe how and to what extent the EMF Research
Fellow will be involved on the projects.

9.

BIOGRAPHICAL SKETCHES
Use the NIH Biographical Sketch Format Page available on the internet at
www.grants.nih.gov/grants/funding/phs398/phs398.html#
Information is requested for the applicant, Mentor and any associate investigators who will be involved with
the projects. The new 4 page NIH format has been adopted. Description of extramurally funded projects
ongoing or completed in the past 3 years should include title, funding source, specific aims, overall goals and
role/responsibilities of individual on project.

10.

RESOURCES AND ENVIRONMENT

Use the NIH Resources format Page available on the internet at
www.grants.nih.gov/grants/funding/phs398/phs398.html#
Describe the research facilities (laboratory space, clinical population, etc.) available for fellowship training. If
computer access or statistical support is available, it should be described in this section.

11.

BUDGET
Use the NIH Form Detailed Budget for Initial Budget Period available on the internet at
www.grants.nih.gov/grants/funding/phs398/phs398.html#
Indicate how the money will be spent. Justify all major expenditures.

12.

OTHER SUPPORT
Use the NIH form Continuation Format Page available on the internet at
www.grants.nih.gov/grants/funding/phs398/phs398.html#
List all current and pending intramural and extramural research funding for the applicant, Mentor and coinvestigators. For each item indicate the grant identification number, grant type, PI, funding source, annual
direct costs, funding period, percent effort, grant title, and brief description of project. For all items indicate
whether there is any scientific or budgetary overlap with the current proposal.

13.

ETHICS
Use the NIH form Continuation Format Page (no page limit) available on the internet at
www.grants.nih.gov/grants/funding/phs398/phs398.html#

Human subjects. For all research involving human subjects, a part of the peer review process will include
careful consideration of protections from research risks, as well as the appropriate inclusion of women,
minorities, and children. The EMF Scientific Review Committee (SRC) will assess the adequacy of safeguards
of the rights and welfare of research participants, and the appropriate inclusion of women, minorities, and
children, based on the information in the application. This evaluation will be factored into the overall score.
The information on the protection of human subjects that you are required to provide in this section is identical
to information that you will be required to provide for IRB at your own institution and are required by most
Federal agencies. This section must address the following items. These can be copied and pasted directly into
your application.
The applicant should include specific measures on how protected health information (as defined by the Human
Health Services) will be handled in accordance with the Privacy Rule of the Health Insurance Portability
Accountability Act (HIPAA).
1.

RISKS TO THE SUBJECTS

a. Human Subjects Involvement and Characteristics
Describe the proposed involvement of human subjects in the work outlined in the Research Design and
Methods section. Describe the characteristics of the subject population, including their anticipated
number, age range, and health status. Identify the criteria for inclusion or exclusion of any subpopulation.
Explain the rationale for the involvement of special classes of subjects, such as fetuses, neonates,
pregnant women, children, prisoners, institutionalized individuals, or others who may be considered
vulnerable populations. Note that 'prisoners' includes all subjects involuntarily incarcerated (for example,
in detention centers) as well as subjects who become incarcerated after the study begins. List any
collaborating sites where human subjects research will be performed, and describe the role of those sites
in performing the proposed research.
b. Sources of Materials
Describe the research material obtained from living human subjects in the form of specimens, records, or
data.
Describe any data that will be recorded on the human subjects involved in the project.
Describe the linkages to subjects, and indicate who will have access to subject identities.
Provide information about how the specimens, records, or data are collected and whether material or data
will be collected specifically for your proposed research project.
c. Potential Risks
Describe the potential risks to subjects (physical, psychological, social, legal, or other), and assess their
likelihood and seriousness to the subjects.
Where appropriate, describe alternative treatments and procedures, including the risks and benefits of the
alternative treatments and procedures to participants in the proposed research.

2.

ADEQUACY OF PROTECTION AGAINST RISKS

a. Recruitment and Informed Consent
Describe plans for the recruitment of subjects (where appropriate) and the process for obtaining informed
consent. If the proposed studies will include children, describe the process for meeting requirements for
parental permission and child assent.
Include a description of the circumstances under which consent will be sought and obtained, who will
seek it, the nature of the information to be provided to prospective subjects, and the method of

documenting consent. Informed consent document(s) need not be submitted to the PHS agencies unless
requested.
b. Protection Against Risk
Describe planned procedures for protecting against or minimizing potential risks, including risks to
confidentiality, and assess their likely effectiveness. Where appropriate, discuss plans for ensuring
necessary medical or professional intervention in the event of adverse effects to the subjects. Studies that
involve clinical trials (biomedical and behavioral intervention studies) must include a description of the
plan for data and safety monitoring of the research and adverse event reporting to ensure the safety of
subjects.
3.

POTENTIAL BENEFITS OF THE PROPOSED RESEARCH TO THE SUBJECTS AND

OTHERS
Discuss the potential benefits of the research to the subjects and others.
Discuss why the risks to subjects are reasonable in relation to the anticipated benefits to subjects and
others.

4.

IMPORTANCE OF THE KNOWLEDGE TO BE GAINED

Discuss the importance of the knowledge gained or to be gained as a result of the proposed research.
Discuss why the risks to subjects are reasonable in relation to the importance of the knowledge that
reasonably may be expected to result.

5.

DATA AND SAFETY MONITORING PLAN (if applicable)

If your research includes a clinical trial, create a heading entitled "Data and Safety Monitoring Plan."
Provide a general description of a monitoring plan that you plan to establish as the overall framework for
data and safety monitoring.
Vertebrate Animals. For all applications involving vertebrate animals, the applicant must address the
following five items. These five points may be copied and pasted directly into the application.
1. Provide a detailed description of the proposed use of the animals in the work outlined in the Research
Design and Methods section. Identify the species, strains, ages, sex, and numbers of animals to be
used in the proposed work.
2. Justify the use of animals, the choice of species, and the numbers to be used. If animals are in short
supply, costly, or to be used in large numbers, provide an additional rationale for their selection and
numbers.
3. Provide information on the veterinary care of the animals involved including the name of the
supervising veterinarian. Include information from the Association for Assessment and Accreditation
of Laboratory Animal Care International: the name of the accredited parent organization (e.g.,
University of X) and the certificate number and date of last inspection.
4. Describe the procedures for ensuring that discomfort, distress, pain, and injury will be limited to that
which is unavoidable in the conduct of scientifically sound research. Describe the use of analgesic,
anesthetic, and tranquilizing drugs and/or comfortable restraining devices, where appropriate, to
minimize discomfort, distress, pain, and injury.
5. Describe any method of euthanasia to be used and the reasons for its selection. State whether this
method is consistent with the recommendations of the Panel on Euthanasia of the American
Veterinary Medical Association. If not, present a justification for not following the recommendations

14.

LITERATURE CITED

15.

APPENDIX
Include letters of support from the department chairs, and associate investigators (required). No page
numbering is necessary for Appendix. The appendix can include

Application for coursework or degree program at an accredited graduate school

Up to 5 publications, manuscripts (accepted for publication), abstracts, patents, or other printed
materials directly relevant to this project. Do not include manuscripts submitted for publication.

Publications in press: Include only a publication list with a link to the publicly available on-line journal article or
the NIH PubMed Central (PMC) submission identification number. Do not include the entire article.
Manuscripts accepted for publication but not yet published: The entire article should be submitted and may be
stapled.
Manuscripts published but an online journal link is not available: The entire article should be submitted and may
be stapled.

Surveys, questionnaires, data collection instruments, clinical protocols, and informed consent
documents. These may be stapled as sets.
Original glossy photographs or color images of gels, micrographs, etc., provided that a photocopy (may
be reduced in size) is also included within the 2-page limit of Items a-d of the research plan. No
photographs or color images may be included in the Appendix that are not also represented within the
Research Plan.

Do not use appendix to circumvent page limitations for research plans. Do not include experimental methods,
protocols or figures that should be incorporated within the research project description.

Applicant/Preceptor (Last, first, middle): ___________________________________________

EMERGENCY MEDICINE FOUNDATION
TABLE OF CONTENTS
Page Numbers
__________

Information Page

__________

Abstract

__________

Table of Contents
Introduction to Revised Application (if applicable)

__________

Research Proposal

__________

Personal Statement

__________

Letter of Support From Preceptor

__________

Biographical Sketch

__________

Resources and Environment

__________

Detailed Budget

__________

Other Support

__________

Ethics

__________

Literature Cited

__________

Appendix

__________

Statement of Conditions

Emergency Medicine Foundation

Information Page
Full Name with Titles:__________________________
Name of Institution:___________________________
Grant Category:______________________________
Project Title:________________________________
Amount Requesting:__________________________
Mentor, if applicable:_________________________

Applicant/Preceptor (Last, first, middle): ___________________________________________

Project Summary/Abstract Section
Enter the text here that is the abstract information for your application. This section must be no longer than 30 lines of text.

Applicant/Preceptor (Last, first, middle): ___________________________________________

Specific Aims Section
Enter the text here that is the specific aims information for your application. One page is recommended.

CONTINUATION PAGE
STAY WITHIN MARGINS INDICATED

PHS 398/2590 (rev. 05/01)

Page___

Number pages consecutively at the bottom throughout the application. Do not use suffixes such as 3a, 3b

Continuation Format Page

Applicant/Preceptor (Last, first, middle): ___________________________________________

INTRODUCTION TO REVISED APPLICATION, if applicable. (Limit 2 pages)
EMF will consider revised proposals, and two additional pages are provided to introduce reviewers to the revised
proposal. Key things to keep in mind when submitting a revised grant:
a. The introduction to the revision should provide a concise summary of reviewers' comments from the previous
application and should, point-by-point, discuss how the revised application has addressed these concerns.
b. Revised applications are not reviewed outside of the normal review process. Such applications may be more
competitive than first-time submissions, but not necessarily so.
c. Revised applications are reviewed as new science. Revised applications will not automatically be considered
better applications within the review process.
d. In the event of a resubmission, the committee attempts to return applications to their original reviewers.
However, regular turn-over of the committee membership prevents the SRS from guaranteeing that a grant
will be reviewed by the same individuals who reviewed the original application.

BIOGRAPHICAL SKETCH
Provide the following information for the Senior/key personnel and other significant contributors.
Follow this format for each person. DO NOT EXCEED FOUR PAGES.
NAME

POSITION TITLE

eRA COMMONS USER NAME (credential, e.g.,

agency login)
EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such as
nursing, include postdoctoral training and residency training if applicable.)
DEGREE
INSTITUTION AND LOCATION
(if
MM/YY
FIELD OF STUDY
applicable)

Please refer to the application instructions in order to complete sections A, B, C, and D of the Biographical Sketch.

Principal Investigator/Program Director (Last, first, middle)

RESOURCES AND ENVIRONMENT

FACILITIES: Specify the facilities to be used for the conduct of the proposed research. Indicate the performance sites and describe capacities, pertinent
capabilities, relative proximity, and extent of availability to the project. Under Other, identify support services such as machine shop, electronics shop, and
specify the extent to which they will be available to the project. Use continuation pages if necessary.
Laboratory:

Clinical:

Animal:

Computer:

Office:

Other:

MAJOR EQUIPMENT: List the most important equipment items already available for this project, noting the location and pertinent capabilities of each.

PHS 398 (Rev. 05/01)

Page ____
Number pages consecutively at the bottom throughout the application. Do not use suffixes such as 3a, 3b.

Resources Format Page

Principal Investigator/Program Director (Last, first, middle)

STATEMENT OF CONDITIONS GOVERNING THE

EMERGENCY MEDICINE FOUNDATION GRANT
It is understood that any Emergency Medicine Foundation Research Grant approved by the Emergency Medicine
Foundation will be made with the following conditions:
1.

Institutional overhead is not allowed.

2.

The principal investigator's institution is associated or organized for humanitarian purposes and is not a
profit making organization.

3.

All reports of work achieved with this grant will acknowledge the support of the Emergency Medicine
Foundation and his or her co-sponsor, if applicable.

4.

Any discovery that arises from work supported in part by the Emergency Medicine Foundation will be
submitted for publication. Two copies of each publication will be furnished to the Emergency Medicine
Foundation.

5.

Independent progress reports by the applicant will be submitted to the Emergency Medicine Foundation midproject, and within thirty days of completion of the funding period. Additional reports may be required. The
Emergency Medicine Foundation will maintain the copyright of all such reports.

6.

Participation in Emergency Medicine Foundation recognition reception during the American College of
Emergency Physicians Scientific Assembly is required. Grant money may not be used for travel to this event.

7.

Participation in the Emergency Medicine Foundation Grantee Workshop is required. Grant funds may not be
used for travel. The Emergency Medicine Foundation will reimburse travel expenses.

8.

Participation in Research Forum to give a poster and lightning oral presentation is required. This event takes
place at the end of your project. Research Forum is held each year during the American College of
Emergency Physicians Scientific Assembly. Grant money may not be used for travel.

9.

If all requirements are met, funding will begin on July 1st. The Emergency Medicine Foundation reserves the
right to terminate payments under this grant at its sole discretion.

10. If the named principal investigator leaves the institution or terminates research in the designated field, all
remaining funds revert to the Emergency Medicine Foundation. If unused funds exist at the completion of
the project, all remaining funds revert to the Emergency Medicine Foundation.
11. Patent rights will conform to institutional standards. If none exist, the Emergency Medicine Foundation
reserves the right to protect such interests.
12. No research proposal will be funded unless the principal investigator and the Fiscal Officer of the sponsoring
institution affirm:

a.
b.
c.
d.
e.

That the investigation(s) proposed in this application are endorsed by the Animal and/or Human
Subjects Committee or other designated body of the preceptor's institution, and
That any research involving human subjects conforms with the principles of the Helsinki Code of
the World Medical Association, and
Research involving animals or human subjects must be approved by the institutional review board
(IRB), or its equivalent, and a copy of the approval or pending approval sent with this application.
IRB approval must be documented prior to dispensation of Emergency Medicine Foundation funds.
That research involving vertebrate animals will conform with the "Guiding Principles in the Care
and Use of Animals" as approved by the Council of the American Physiological Society.
Research involving vertebrate animals must have approval from the institutional Animal Care and
Use Committee.

___________________________________ /________________________________
Date Signature of Principal Investigator Type Name of Principal Investigator
___________________________________ /________________________________
Date Signature of Mentor, if applicable Type Name of Mentor
_________________________________________/______________________________
Date
Signature of Fiscal Officer
Type Name of Fiscal Officer